Provider Demographics
NPI:1861954992
Name:MCLEAN, NIA DANIELLE
Entity type:Individual
Prefix:
First Name:NIA
Middle Name:DANIELLE
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NIA
Other - Middle Name:DANIELLE
Other - Last Name:MCLEAN-JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1208 E CHURCHVILLE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-3485
Mailing Address - Country:US
Mailing Address - Phone:410-893-4600
Mailing Address - Fax:
Practice Address - Street 1:14456 OLD MILL RD STE 101
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-2885
Practice Address - Country:US
Practice Address - Phone:410-893-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-06
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC17299101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health